Ativan (Lorazepam) Drug Information

Why Ativan Is Used After Surgery, Risks and Side Effects

Anesthesia and Surgery Image
Ativan May Be Used as Part of Your Anesthesia. Photo: © Andrew Olney/Getty Images

What is Ativan?

Ativan, also known as lorazepam, is a benzodiazepine medication that is available by prescription.  Ativan increases the effect of a chemical in the brain called a neurotransmitter, causing relaxation and sedation.

Why is Ativan Used

Ativan is used for a wide variety of purposes. Before surgery, Ativan may be given to help calm a patient, and may be combined with anesthesia before, during or after the procedure.

 

After surgery, Ativan can be used to improve sleep, treat anxiety, decrease agitation, improve symptoms of postoperative delirium and enhance relaxation.  It is also used as a treatment for seizures and is often given to stop a seizure or to prevent a seizure in a patient who has been having multiple seizures while hospitalized.

In the critical care areas, Ativan may be given to help the patient tolerate the ventilator or a bedside procedure.  In this case, the medication may be given periodically as an IV injection, or may be given continuously as an IV drip. 

Ativan may also be given as a treatment for the symptoms of withdrawal from alcohol or other medications, and may help reduce the chances of a seizure in individuals who are alcohol dependent.  It can be used in the treatment of schizophrenia and may be used to decrease the nausea and vomiting that patients experience after chemotherapy.

How Ativan is Given

Ativan is available as a syrup, pill, an IV injection or an injection into the muscle.  An injection into the muscle is only recommended if IV access is unavailable and the medication must be given. 

Typical Dosing of Ativan

Ativan is given at the smallest effective dose.  For some individuals this may be a dose as small as half of a milligram, for others, larger doses may be necessary.

  Oral doses are typically higher than IV and IM doses.  An individual who requires half a milligram when given the IV form may receive a full milligram or more when taking the medication by mouth. 

Side Effects of Ativan

The major side effect associated with Ativan is sedation, which is often a desired effect of the medication.  

This medication can cause amnesia, especially in higher doses.  When given prior to a procedure, the patient may remember little or nothing of the time immediately following the dose.

Decreased respiratory drive.  This medication should not be given with other medications that decrease breathing (sleeping pills, prescription pain medication) without proper monitoring in a hospital setting. 

Children and older adults are more likely to have a reaction to the medication where it causes agitation and anxiety instead of relieving it.

Older adults, particularly the elderly, may be extremely sensitive to this medication and should have an initial dose that is very low to avoid unwanted side effects including agitation, hallucinations and aggression.

 

Ativan May Require a Taper

Individuals who take this medication for an extended period of time should not stop taking the medication abruptly as withdrawal symptoms may occur.  It is safer to reduce the dosage over time. 

Ativan in Pregnancy and Breast Feeding

This medication is Category D, meaning that there is evidence that this medication could cause harm to a fetus.  It should only be used in pregnant women when there is significant benefit versus risk to the fetus.  Prolonged use during pregnancy may result in the infant experiencing withdrawal after birth.

This medication should not be used by women who are breastfeeding, as it can be passed to the infant and can cause sedation and impaired breathing.

Ativan Warnings

This medication should not be taken by individuals with liver failure and should be used with caution in those who have liver disease. 

This medication should not be taken before driving or operating machinery.

Source:

Lorazepam Monograph.  Accessed March 2016. http://www.drugs.com/monograph/lorazepam.html

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